Membership Hold Form

Not A Termination Request

Form must be submitted at least 5 business days before next draft date for changes to be effective for that draft date.

HOLD FOR:

Please Select

1 month

2 months

3 months

I understand that my draft will automatically restart after my hold period.:I understand that Holds for less than one (1) month are not available:I understand that my hold cannot be applied retroactively and I must allow at least 5 days for the hold to be applied to my account:I understand that if I cancel during the Hold Period, I must submit a separate Cancellation form and it will be subject to the Cancellation Policy per my Membership Agreement:

Membership Cancellation Form - 30 Day Notice

Your account will be cancelled after the next billing cycle. We will cancel your draft automatically. A copy of this cancellation will be emailed to you for your records.

State:

Select a State

Alabama

Alaska

Arizona

Arkansas

Armed Forces (the) Americas

Armed Forces Europe

Armed Forces Pacific

California

Colorado

Connecticut

Delaware

Florida

Georgia

Hawaii

Idaho

Illinois

Indiana

Iowa

Kansas

Kentucky

Louisiana

Maine

Maryland

Massachusetts

Michigan

Minnesota

Mississippi

Missouri

Montana

Nebraska

Nevada

New Hampshire

New Jersey

New Mexico

New York

North Carolina

North Dakota

Ohio

Oklahoma

Oregon

Pennsylvania

Puerto Rico

Rhode Island

South Carolina

South Dakota

Tennessee

Texas

Utah

Vermont

Virginia

Washington

Washington, D.C.

West Virginia

Wisconsin

Wyoming

I am canceling because:

Illness

Financial Burden

Moving

Do Not Use

Unstasfied with Programs/Service (please comment)

Joined Another Facillity

Other

Cleanliness Of Facility:

Excellent

Good

Average

Poor

Friendliness/helpfulness of Front Desk staff:

Excellent

Good

Average

Poor

Friendliness/helpfulness of Wellness staff:

Excellent

Good

Average

Poor

Quality of programs:

Excellent

Good

Average

Poor

By submitting this form, I am giving BRICK my 30 day written notice to cancel my membership. I understand that my membership will be canceled 30 days from the date this form was submitted. I understand that I will be charged/debited one additional month, for the use of the facility during my 30 day cancellation period. Upon completion of the 30 day cancellation period, my membership shall then be considered terminated. Should I choose to rejoin BRICK after the termination of my membership, I will have to pay at the then current rate: